title: Tumor feeding artery reconstruction with multislice spiral CT in the diagnosis of pelvic tumors of unknown origin.
abstract: OBJECTIVE
  We aimed to compare multislice spiral computed tomography (MSCT) angiography diagnosis with both surgical findings and postoperative pathological results in patients with pelvic tumors of unknown origin. In addition, the diagnostic accuracy of MSCT angiography was compared with that of routine computed tomography for tumor feeding artery volume reconstruction to determine the origin and nature of pelvic tumors.
  
  
  METHODS
  The records of 43 patients with pelvic tumors of unknown origin who underwent MSCT angiography were retrospectively reviewed. Volume reconstructions using add vessel and merge views methods were performed for abdominal and pelvic blood vessels. The tumor origin was identified based on observations of the origin, number, morphology, starting/ending locations, route, and distribution of the tumor feeding arteries.
  
  
  RESULTS
  Overall, the mean tumor diameter was 9.8±3.5 cm (range, 4.2-23.5 cm); 11 tumors (25.6%) were cystic in nature; and 32 tumors (74.4%) were either solid/cystic or solid in nature. When considering all MSCT angiography examinations used to predict the nature of the tumor (e.g., malignant or benign), the sensitivity and specificity were 77.3% and 95.2%, respectively. The positive and negative predictive values were 94.4% and 80%, respectively. The overall diagnostic accuracy was 86.05% with an area under the curve of 0.961 (95% confidence interval, 0.913-1.000).
  
  
  CONCLUSIONS
  MSCT angiography volume reconstruction for pelvic tumor feeding arteries of unknown origin is highly valuable for localization, qualitative diagnosis, and quantitative diagnosis of pelvic tumors.
authors.affiliation: From the Departments of Radiology (H.H.) and Surgery (Y.Z. e-mail: zhuyingchang@163.com), Nanhai Hospital, Nanfang Medical University, Foshan, Guangdong, China; the Department of Gynecology (Y.H.), State Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, China.
authors.forename: Hai-Jing
authors.initials: HJ
authors.lastname: Hu
authors.forename: Yong-Wen
authors.initials: YW
authors.lastname: Huang
authors.forename: Ying-Chang
authors.initials: YC
authors.lastname: Zhu
mesh_terms: D000328:Adult; D000368:Aged; D000792:Angiography / Q000379:methods; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008297:Male; D008875:Middle Aged; D009382:Neoplasms, Unknown Primary; D010386:Pelvic Neoplasms / Q000098:blood supply* / Q000000981:diagnostic imaging* / Q000556:secondary; D012189:Retrospective Studies; D036542:Tomography, Spiral Computed; D055815:Young Adult